Journal of clinical monitoring and computing
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J Clin Monit Comput · Feb 1998
Comparative StudyDevelopment and assessment of a computer-based preanesthetic patient evaluation system for obstetrical anesthesia.
Computerization of the medical record in various outpatient settings has been successful but for anesthesiologists, the preoperative visit differs significantly. This study implemented a computerized version of a structured preanesthetic evaluation questionnaire that we had previously developed and which provided a starting point for developing a suitable vocabulary and workflow. ⋯ The introduction of a computer into the physician-patient relationship did not disrupt the examination. It markedly reduced time-consuming tasks (such as dictation), captured far more detail than found in our previously dictated and handwritten notes and provided immediately available data for quality assurance activities.
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J Clin Monit Comput · Feb 1998
The Diatek Arkive "Organizer" patient information management system: experience at a university hospital.
To install and successfully use early commercial automatic anesthesia recordkeepers, the Diatek Arkive "Organizer" units, in the operating rooms at a major university medical center. ⋯ Total resistance to the new devices on the part of a few vocal faculty members was a major factor in the ultimate downfall of the system. The method of introduction, and especially the lack of involvement of faculty, residents, surgeons, operating room personnel, hospital computer personnel, and the hospital administration in the installation also played a role in the failure of the system. Lack of a workable training mechanism for new residents prevented that user group from rapidly gaining comfort with the systems.
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J Clin Monit Comput · Feb 1998
Comparative StudyMethane influences infrared technique anesthetic agent monitors.
During closed-circuit anesthesia, anesthetic vapor analysis by infrared absorption at 3.3 microm can be influenced by the concentration of accumulated methane, resulting in inaccurate readings of anesthetic concentrations. The current study examined the influence of different known methane concentrations on the analysis of halothane or isoflurane concentrations by the infrared absorption technique. ⋯ In closed circuit or low-flow anesthesia, in which methane can accumulate, infrared measuring techniques for potent inhalation anesthetics that do not use the 3.3 microm wavelength appear to be preferable.
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J Clin Monit Comput · Feb 1998
TWITCHER: a device to stimulate thumb twitch response to ulnar nerve stimulation.
To design and fabricate a device to simulate evoked thumb adduction in response to ulnar nerve stimulation. ⋯ TWITCHER has been well received by participants in simulation exercises including the use of neuromuscular blocking drugs.
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J Clin Monit Comput · Feb 1998
Three years experience with a patient data management system at a neonatal intensive care unit.
We report about our experience with the patient data management system (PDMS) Hewlett Packard CareVue 9000 at two neonatal ICUs. We describe our PDMS configuration (hard- and software), local adjustments and enhancements such as knowledge based systems for calculating the parenteral nutrition of newborn infants (VIE-PNN), for advising medication (VIE-Nmed), and for managing mechanical ventilation (VIE-VENT), and the results of a structured interview with our staff members about the acceptance of the system. Despite some criticism nearly all collaborators liked the system, especially because of its time saving automated documentation of vital data and mechanical ventilation parameters. ⋯ Main points of critique were the system's therapy planning facilities (medication administration records), the restrictive facilities for documenting patient care and the yet unsolved problems of data evaluation and export. PDM systems have to be constantly adapted to the user's needs and to the changing clinical environment. Living with the system asks for an intensive dialog with the system and its functionalities, for creativity and well defined ideas about the future system development.